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Remicade and Zirtec

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Crohn's Disease
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Posted 1/12/2011 9:15 PM (GMT 0)
On my last two infusions, I have been getting severe muscle pains in my legs.  My GI thinks it could be the start of the antibodies building up.  He told me to take Zirtec 5 days before and after the infusion and this should help.

My question is has anyone done this before and does it help.  Also, how long before the Zirtec becomes useless?  I am starting to get disharden as nothing seems to be helping me anymore and the CD is getting out of control.  My GI said they are 2 options left which would be to up my dose or to add 6MP...but since I tried 6MP already with adverse affects the only thing left is to up the dose.  If I am getting antibodies though..this isn't the best option.

Any advice would be great.

Posted 1/12/2011 9:22 PM (GMT 0)
There is a test to check for antibodies - perhaps that will tell you for sure. I'm not sure how the test works though - if there is a mark that determines you've got too many antibodies (therefore it's a problem). My hubby's GI doesn't get that test, because he says everyone on remicade will have some antibodies. I wonder if the test will tell you how likely you are to have an adverse reaction based on the amount of antibodies. Something to ask.

Also, I've never heard of zyrtec being used to prevent remicade side effects. I know they give you benedryl during the infusion. I hope they've been giving you 40mgs of solumedrol along with the remicade as well to prevent some of the reactions.

One other theory I've heard practiced is to take 20 mgs of prednisone for 3 days before the infusion, and 2 days after (at lower doses) and then stop. I personally think that this has a better chance of suppressing reactions, though it does mean more pred.

I hope you get some answers. What about cimzia? Perhaps you can give that a try. I hear it works slightly differently from Humira and Remicade, so perhaps that will work better for you.

Hang in there. Hopefully it'll get better soon. Also, maybe you can take 6-mp/Imuran in lower doses just to keep your body from building up antibodies, instead of needing it to be at the therapeutic dosage. Just somethings to consider.

(((Hugs))) I hope you'll get some good answers and start feeling better and have a good course of action for the future.

PV
Posted 1/13/2011 12:00 AM (GMT 0)
I started to have reactions to my Remicade infusions. I was told to take Zyrtec for three days before the infusions. Zyrtec is an antihistamine like Benadryl. It is longer acting then Benadryl. Unfortunately, Zyrtec turned me into a zombie. about 1.5 years after I started Remicade, the GI upped the dosage and that helped for a while. I ended up having to stop Remicade after 2.5 years because it no longer was working for me.

This is the info on the test for antibodies that PV mentioned:
PROMETHEUS® Serum Infliximab/ HACA Measurement is a test to detect human anti-chimeric antibodies (HACA) that may develop after receiving infliximab infusions. Patients who develop these antibodies at higher levels are at a greater risk of having complications from future infliximab infusions. Also, patients with higher antibody levels may have a shorter duration of benefit from the infliximab.

Be aware that not all insurance companies will pay for this test.

If Remicade no longer works for you there are other biologics that you could try; Humira, Cimzia. I tried Humira but had a severe reaction soon. I am on Simponi now. It is not approved for CD. I have Ankylosing Spondylitis and it is approved for that. It is keeping my CD in remission. My GI feels at some point in the future, Simponi will be approve for CD.
Posted 1/13/2011 1:27 AM (GMT 0)
This is similar to what my GI told me. If I was going to restart Remicade or in people that are starting to react. He told me to take claritan and pepcid 5 days before and 5 days after. Some receptors that both of these block, they each block a different one. He said he has had good success with patients doing that, I chose not to go back on Remicade so I can't tell you if it helped.
Posted 1/13/2011 1:27 AM (GMT 0)
I would sometimes get chest tightness or joint pain toward the end of my infusion, so my GI slowed down my infusion rate and had me take Zyrtec a week before and a week after the infusion. Haven't had any problems since doing this (almost 2 years, I think)

He never mentioned that I was building up antibodies, just that I was having reactions to Remicade.

Posted 1/13/2011 2:45 AM (GMT 0)
hmm I use to take Zyrtec religiously while on Remi for my allergies before they made it OTC then I switched however they had me premed with pred and at times had to give me more there for allergy issues
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